NPI | 1558614024 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05013391A) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070017366) |
Enumeration Date | 2012-10-22 |
Last Update Date | 2022-12-08 |